title: Impulse control and related disorders in Parkinson's disease patients treated with bilateral subthalamic nucleus stimulation: a review.
abstract: Recently, impulse control and related disorders including punding and the dopamine dysregulation syndrome (DDS) have been increasingly recognized in treated patients with Parkinson's disease (PD). Especially the impulse control disorders (ICD) such as pathological gambling, hypersexuality, compulsive eating and buying may have dramatic repercussions on family, personal and professional life. Drug replacement therapy (DRT) is believed to play an important role in the onset of these behavioral disturbances. Although deep brain stimulation (DBS) of the subthalamic nucleus (STN) might be a therapeutic option for those patients with DRT-related behavior, it may also induce ICD. So far, little is known about the relationship between STN DBS and impulse control and related disorders. Our aim was to review the current knowledge on this relationship in PD patients. The available studies showed that stimulation of the STN is associated with both favorable and negative outcome in terms of impulse control and related disorders. Preoperative disorders may resolve or improve after STN DBS, but these can also worsen or show no change at all. Moreover, STN DBS can also reveal or even induce ICD. Possible explanations for this variability are proposed and suggestions for clinical management are given.
authors.affiliation: Department of Neurology, Maastricht University Medical Center, P. Debyelaan 25, 6202 AZ Maastricht, The Netherlands. m.broen@student.maastrichtuniversity.nl
authors.forename: Martijn
authors.initials: M
authors.lastname: Broen
authors.forename: Annelien
authors.initials: A
authors.lastname: Duits
authors.forename: Veerle
authors.initials: V
authors.lastname: Visser-Vandewalle
authors.forename: Yasin
authors.initials: Y
authors.lastname: Temel
authors.forename: Ania
authors.initials: A
authors.lastname: Winogrodzka
mesh_terms: D000328:Adult; D046690:Deep Brain Stimulation / Q000009:adverse effects; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000209:etiology / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D010300:Parkinson Disease / Q000628:therapy*; D020531:Subthalamic Nucleus / Q000503:physiopathology*